Escape to victory: the refugees who will run at the Rio Olympics

It was in the middle of the night when Yiech Pur Biel fled the only home he had ever known as fast as his ten-year-old legs would carry him. There was no time to gather any belongings. His mother urged him and his two siblings to run for the bush. Later, peeking through the tall, dense grass and vegetation of South Sudan, Yiech saw the roaring flames and smelled the smoke engulfing his village.

Eleven years later, Yiech is in Kenya, training for a very different kind of run. He will be competing in the 800 metres race at the Olympic Games in Rio, as part of the first ever “Team Refugee”. The initiative, instigated and funded by the International Olympic Committee (IOC), is intended to raise awareness of the worldwide refugee crisis. Tegla Loroupe, Kenya’s former marathon world record-holder, is leading the team. She selected the Kenyan-based athletes from trials held at the Kakuma and Dadaab refugee camps and has spent nine months coaching them.

The team includes two Syrian swimmers, two judokas from the Democratic Republic of Congo and a marathon runner from Ethiopia, who had fled to countries such as Belgium, Germany, Brazil and Luxembourg. Half of the team is made up of middle-distance runners based in Kenya, all from South Sudan.

Yiech escaped from his country in 2005, the last year of the Second Sudanese Civil War, which had been raging since 1983. In the decade before he was born, more than 20,000 Sudanese boys and girls fled their homes in an effort to escape being killed or recruited as child soldiers. Though most of them were younger than ten, they walked thousands of miles. Half of them never made it, perishing on the journey from illness, snakebites, attacks by wild animals or malnutrition. Of those who survived, most never saw their family again.

As he sits recovering from an early-morning run in the leafy grounds of the athletes’ small training compound just outside Nairobi, Yiech recalls how his family spent days living in the bush while on the run. “There was no food, so we ate the fruits. But the fruits were not enough, so we even ate the leaves from the trees.” When they returned to their burned-out village, everything had been destroyed. “They even took the cows.”

Yiech’s mother decided to cross into Ethiopia to look for food, taking the two youngest children. “They left me with my neighbours, because I was the oldest,” he says. The family still hoped that Yiech’s father, who had been missing for two years after being forcibly recruited to fight, would return. He did not. A neighbour took Yiech with her to the Kakuma refugee camp in Kenya, which is still his home today.

For a ten-year-old living without his family, the main challenge was logistics. “You go to school, and afterwards you must come back and cook for yourself and fetch water,” he explains. He laughs suddenly as he remembers. “The first time I cooked – oh, I made food that you cannot eat!”

Yiech was encouraged to try out for the team by his friend James Nyang Chiengjiek, a 28-year-old 400 metres runner from South Sudan who captains the Olympic refugees. As a child, James would meet up with two of his friends to herd cattle and play on the banks of the River Nile, spending hours competing over who could catch the biggest fish. One day when he was 13, his friends didn’t turn up. Running home, he found that they had been recruited as child soldiers. He panicked. “Everyone knew that as soon as they recruit your friends, they will come for you, too, and take you by force,” James explains. “I thought to myself, ‘I cannot be killed.’”

James talked to his mother, who urged him to go into hiding. While wandering through the dense forests, he met Ndouk, a mother-of-two, who took him under her wing. “I was so afraid, but she shared corn and other food with me.” Ndouk said she was heading for a UN compound. James followed – a decision that probably saved his life.

The other refugee athletes have similar stories. Most haven’t seen their parents and siblings since they were children. Their experiences are still raw but they say they try not to talk about it too much. “It is very sad,” James admits. “We don’t go deep, because the emotion can overwhelm.” Instead, everyone is focused on the competition ahead.

“The Olympics are like God opening a door. Not just for me but for all refugees,” says James. “You see, when we are there, the most important thing we’ll be promoting is peacemaking.”

After the competition, James intends to carry on training and working with other refugees. “We have so many young people. We have to take them with us, train with us. That is very important. We’ve been helped by the IOC, UNHCR, Tegla – so if someone helped you, later on, you have to do something good for others.”

“I want to serve people wherever I go,” says Yiech, who intends to study international relations. “The world has the wrong idea about refugees. Now we have a chance to show the world that we are human beings like other people.”

David had taken the same tablets for years. Why the sudden side effects?

David had been getting bouts of faintness and dizziness for the past week. He said it was exactly like the turns he used to get before he’d had his pacemaker inserted. A malfunctioning pacemaker didn’t sound too good, so I told him I’d pop in at lunchtime.

Everything was in good order. He was recovering from a nasty cough, though, so I wondered aloud if, at the age of 82, he might just be feeling weak from having fought that off. I suggested he let me know if things didn’t settle.

I imagined he would give it a week or two, but the following day there was another visit request. Apparently he’d had a further turn that morning. The carer hadn’t liked the look of him so she’d rung the surgery.

Once again, he was back to normal by the time I got there. I quizzed him further. The symptoms came on when he got up from the sofa, or if bending down for something, suggesting his blood pressure might be falling with the change in posture. I checked the medication listed in his notes: eight different drugs, at least two of which could cause that problem. But David had been taking the same tablets for years; why would he suddenly develop side effects now?

I thought I’d better establish if his blood pressure was dropping. I got him to stand, and measured it repeatedly over a period of several minutes. Not a hint of a fall. And nor did he now feel in the slightest bit unwell. I was stumped. David’s wife had been watching proceedings from her armchair. “Mind you,” she said, “it only happens mid-morning.”

The specific timing made me pause. I asked to see his tablets. David passed me a carrier bag of boxes. I went through them methodically, cross-referencing each one to his notes.

“Well, there’s your trouble,” I said, holding out a couple of the packets. One was emblazoned with the name “Diffundox”, the other “Prosurin”. “They’re actually the same thing.”

Every medication has two names, a brand name and a generic one – both Diffundox and Prosurin are brand names of a medication known generically as tamsulosin, which improves weak urinary flow in men with enlarged prostates. Doctors are encouraged to prescribe generically in almost all circumstances – if I put “tamsulosin” on a prescription, the pharmacist can supply the best value generic available at that time, but if I specify a brand name they’re obliged to dispense that particular one irrespective of cost.

Generic prescribing is good for the NHS drug budget, but it can be horribly confusing for patients. Long-term medication keeps changing its appearance – round white tablets one month, red ovals the next, with different packaging to boot. And while the box always has the generic name on it somewhere, it’s much less prominent than the brand name. With so many patients on multiple medications, all of which are subject to chopping and changing between generics, it’s no wonder mix-ups occur. Couple that with doctors forever stopping and starting drugs and adjusting doses, and you start to get some inkling of quite how much potential there is for error.

I said to David that, at some point the previous week, two different brands of tamsulosin must have found their way into his bag. They looked for all the world like different medications to him, with the result that he was inadvertently taking a double dose every morning. The postural drops in his blood pressure were making him distinctly unwell, but were wearing off after a few hours.

Even though I tried to explain things clearly, David looked baffled that I, an apparently sane and rational being, seemed to be suggesting that two self-evidently different tablets were somehow the same. The arcane world of drug pricing and generic substitution was clearly not something he had much interest in exploring. So, I pocketed one of the aberrant packets of pills, returned the rest, and told him he would feel much better the next day. I’m glad to say he did.